Choi Kyujin, Heo Jihye, Oh Soo-Young, Yu Jonghan, Sung Juyoung, Kim Insung, Jeong Su-Min, Kang Danbee
Department of Family Medicine, Seoul National University Hospital, 1, Gwanak-ro, Gwanak-gu, Seoul, Republic of Korea.
Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Sciences and Technology (SAIHST), Sungkyunkwan University, 81 Irwon-ro, Gangnam- Gu, Seoul, 06351, Republic of Korea.
J Autism Dev Disord. 2025 Jun 11. doi: 10.1007/s10803-025-06926-5.
This study aimed to examine the risk of neurodevelopmental disorders (NDDs) in cJihye Heohildren born to female cancer survivors under 40 years old. Using nationwide retrospective data from the Korean National Health Insurance Service between January 1, 2005, and December 31, 2019, we included 19,474 children born to female cancer survivors under 40 years old. Propensity-score matching (1:3) with 58,422 controls born to women without cancer was conducted. NDDs were identified using ICD-10 codes. Hazard ratios (HRs) were calculated to assess the relative risk. Children born to cancer survivors had a higher overall risk of NDDs (HR = 1.10; 95% CI 1.05-1.15), with specific elevated risks for cerebral palsy (HR = 1.38; 95% CI 1.05-1.81), developmental delay (HR = 1.16; 95% CI 1.06-1.26), and epileptic and febrile seizures (HR = 1.06; 95% CI 1.01-1.12). The risk was particularly elevated in children whose mothers were diagnosed with cancer during pregnancy (HR = 1.26; 95% CI 1.08-1.47). However, for births occurring more than 5 years after the cancer diagnosis, the difference in NDDs risk was not statistically significant (HR = 1.07; 95% CI 0.98-1.16). The offspring of young female cancer survivors had an increased risk of NDDs compared with the control group. When young female cancer survivors desire pregnancy, healthcare providers should offer appropriate counseling and surveillance for potential adverse NDDs in their offspring.
本研究旨在调查40岁以下女性癌症幸存者所生子女患神经发育障碍（NDDs）的风险。利用韩国国民健康保险服务局2005年1月1日至2019年12月31日的全国性回顾性数据，我们纳入了19474名40岁以下女性癌症幸存者所生的子女。对58422名无癌症女性所生的对照进行了倾向得分匹配（1:3）。使用国际疾病分类第十版（ICD-10）编码识别NDDs。计算风险比（HRs）以评估相对风险。癌症幸存者所生子女患NDDs的总体风险更高（HR = 1.10；95%置信区间1.05 - 1.15），其中脑瘫（HR = 1.38；95%置信区间1.05 - 1.81）、发育迟缓（HR = 1.16；95%置信区间1.06 - 1.26）以及癫痫和热性惊厥（HR = 1.06；95%置信区间1.01 - 1.12）的风险尤其升高。母亲在孕期被诊断出癌症的子女风险特别高（HR = 1.26；95%置信区间1.08 - 1.47）。然而，对于癌症诊断后5年以上出生的情况，NDDs风险差异无统计学意义（HR = 1.07；95%置信区间0.98 - 1.16）。与对照组相比，年轻女性癌症幸存者的后代患NDDs的风险增加。当年轻女性癌症幸存者想要怀孕时，医疗服务提供者应为其后代潜在的不良NDDs提供适当的咨询和监测。
